1. (a) This section applies only to a reduction in out-of-pocket expenses made by or on behalf of an enrollee for a prescription drug covered by the enrollee's health benefit plan for which:

   1. (1) a generic equivalent does not exist;

   2. (2) a generic equivalent does exist but the enrollee has obtained access to the prescription drug under the enrollee's health benefit plan using:

      1. (A) a prior authorization process;
      2. (B) a step therapy protocol; or
      3. (C) the health benefit plan issuer's exceptions and appeals process;
   3. (3) an interchangeable biological product does not exist; or

   4. (4) an interchangeable biological product does exist but the enrollee has obtained access to the prescription drug under the enrollee's health benefit plan using:

      1. (A) a prior authorization process;
      2. (B) a step therapy protocol; or
      3. (C) the health benefit plan issuer's exceptions and appeals process.
2. (b) An issuer of a health benefit plan that covers prescription drugs or a pharmacy benefit manager shall apply any third-party payment, financial assistance, discount, product voucher, or other reduction in out-of-pocket expenses made by or on behalf of an enrollee for a prescription drug to the enrollee's deductible, copayment, cost-sharing responsibility, or out-of-pocket maximum applicable to health benefits under the enrollee's plan.

Added by Acts 2023, 88th Leg., R.S., Ch. 489 (H.B. 999), Sec. 2, eff. September 1, 2023.